Trichilemmoma D23.L

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Trichilemmoma desmoplastic; Tricholemmoma

History
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French and Headington, 1962

Definition
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Benign epithelial tumor originating from cells of the outer hair root sheath. S.a. Adnexal tumours with hair differentiation.

Localization
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Located in the head area (nose, upper lip, cheeks).

Clinical features
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Solitary, 0.5-3 cm large, skin-coloured, very solid (consistency like wood), on the base usually well movable tumour with predominantly papillomatous or also verrucous surface. S.a. proliferating tricholemmal cyst. Multiple tricholemmomas can be indications of a Cowden's syndrome.

Histology
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Sharply delineated tumor clusters localized in the upper dermis, separated by a hyalinized, eosinophilic membrane. Tumor parenchyma consisting of large, glassy-looking, PAS-positive cells with monomorphic nuclei. Few mitoses. Isolated dyskeratoses in the centre of the tumour. At the edge of the tumor strands a palisade position of the nuclei is visible.

Differential diagnosis
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Therapy
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Surgical removal in healthy individuals. In case of insufficient surgical removal, danger of local recurrence, see also tricholemic tumor, proliferating.

Note(s)
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The desmoplastic tricholemmoma is considered a histological variant with a prominent proliferation of the connective tissue tumor stroma.

Literature
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  1. Ackermann B et al (1980) Tricholemmoma. At J Dermatopathol 2: 207-224
  2. Headington JT, French AJ (1962) Primary neoplasms of the hair follicle. Arch Dermatol 86: 430-441
  3. Kaddu S et al (2003) Adnexal tumors with hair follicle differentiation. In: Kerl H et al (ed.) Histopathology of the skin. Springer, Berlin Heidelberg New York, S. 667

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Last updated on: 29.10.2020